Quantifying the Time-Varying Association Between Objectively Measured Physical Activity and Mortality in US Older Adults over a 12-Year Follow-Up Period: the NHANES 2003-2006 Study.

Neha Agarwala,Vadim Zipunnikov,Ciprian Crainiceanu,Andrew Leroux

BMJ EVIDENCE-BASED MEDICINE（2024）

Univ Maryland Baltimore Cty | Johns Hopkins Univ | Univ Colorado Anschutz Med Campus

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Abstract

Objectively measuring physical activity (PA) has consistently shown an association with reduced all-cause mortality risk in cross-sectional studies. However, the strength of this association may change over time. We quantify the time-varying, covariate-adjusted association between the total volume of PA and all-cause mortality over a 12-year follow-up period using Cox regression with a time varying effect of population-referenced quantile total activity count adjusted for traditional risk factors. Analyses focus on participants 50-84 years old with adequate accelerometer wear time and without missing covariates. The findings suggest that (1) the use of baseline PA in Cox models with long follow-up periods may be inappropriate without time-varying effects and (2) the use of accelerometry derived volume of PA in risk score calculations may be most appropriate for short-term to medium-term risk scores.

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Key words

Physical Fitness,Health Planning,Methods,Public health,Behavioral Disciplines and Activities

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